Peter Attia says he no longer believes keto’s benefits are mainly driven by insulin suppression

What was said

"What has changed is my belief as to why it works. You see, I used to believe that the diet worked through insulin suppression. Um but today I I don't think that's the case. Today, I think the diet works um for the same reason many restrictive diets work, which is it makes it easier to control energy intake."

Peter Attia says he still views ketogenic diets as effective, but that he has changed his view on why they work. He says he previously believed keto worked primarily through insulin suppression, but now believes it can work largely because it makes energy intake easier to control. He adds that, in his view, energy imbalance drives visceral and ectopic fat accumulation, with hyperinsulinaemia “along for the ride”, and that lowering insulin without addressing energy imbalance would not resolve those problems.